bromochloroacetic-acid and Papilloma--Inverted

Topics: Adenocarcinoma; Biomarkers, Tumor; Carcinoma, Squamous Cell; Diagnosis, Differential; Hamartoma; Humans; Inflammation; Keratins; Nasal Mucosa; Nasopharyngeal Neoplasms; Papilloma, Inverted; Paranasal Sinus Neoplasms; Polyps; Teratoma

Inverted ductal papilloma (IDP) is a type of ductal papilloma arising in ducts of minor salivary glands. Very few cases, and no cases in Japan, have been reported. Reported herein is a case of IDP with a review of the literature. The patient was a 49-year-old man presenting with a lump in the right buccal mucosa of the premolar area of the mandible. The tumor was excised en bloc after a biopsy diagnosis of IDP. On the surface of the covering epithelium, an opening was seen to be filled with mucinous material. On cut surface the opening led to the tumor cavity. The major portion of the tumor parenchyma was made up of papillary proliferation of basaloid squamous cells. Some crypts, microcysts, and mucous cells were seen. There were no findings suggestive of a malignant tumor. The patient's postoperative course was uneventful and there has been no recurrence after 1 year's follow up. Immunohistochemical analysis of the present case supports the hypothesis that IDP originates from squamous metaplasia and proliferation of minor salivary gland duct cells.

Topics: Biomarkers, Tumor; Humans; Keratins; Male; Middle Aged; Mouth Mucosa; Mucin-1; Papilloma, Inverted; Salivary Ducts; Salivary Gland Neoplasms; Salivary Glands, Minor

Cytokeratin (CK) expression was studied in 22 sinonasal inverted papillomas. Columnar (respiratory) epithelium in inverted papillomas abundantly expressed CK7, CK8, CK18, and CK19. Immunoreactivity for CK5/14 and CK17 was found in basal and parabasal/suprabasal cells. Transitional (cuboidal) and squamous epithelium in inverted papillomas comparably expressed CK7, CK8, CK18, and CK19. In addition CK13 was found in subluminal and surface cells. Immunoreactivity for CK5/14 and CK17 involved all layers of the epithelium. In nonpapillomatous nasal mucosa adjacent to inverted papillomas, CK expression in columnar (respiratory) epithelium exactly matched the findings in inverted papillomas. Transitional (cuboidal) and squamous epithelium in nonpaillomatous mucosa were negative for CK7, CK8, CK18, and CK19. CK13 was expressed in subluminal and surface cells. Immunoreactivity for CK5/14 and CK17 was restricted to basal and parabasal/suprabasal cells. Conclusively, transitional (cuboidal) and squamous epithelium in inverted papillomas but not in the adjacent mucosa coexpress CKs typical for columnar and squamous differentiation.

Topics: Adult; Aged; Cell Transformation, Neoplastic; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Nasal Mucosa; Papilloma, Inverted; Paranasal Sinus Neoplasms

Inverted papilloma is a benign sinunasal tumor, characterized by aggressive nature and tendency to recur. This tumor also has a significant malignant potential (10%). In spite of extensive research in the past the origin of inverted papilloma is not known.. A retrospective analysis of the clinical data of 28 patients suffering from inverted papilloma of the nose and paranasal sinuses with regard to symptoms, clinical examination, computed tomography findings, and operative management was performed. Furthermore, immunohistochemical examinations of the cytokeratin profile of 12 specimens were carried out.. The most presenting symptoms were unilateral nasal obstruction (17.61%) and rhinorrhea (7.25%). Polyposis was seen endoscopically in 19 cases (68%), so that in many patients in inverted papilloma became suspicious in the CT scan. The surgical therapy was dictated by the extent of the tumor, so that the tumor was treated by lateral rhinotomy (n = 17), midfacial degloving (n = 5), endonasal endoscopic surgery (n = 5), and craniofacial resection due to an infiltration of the frontal skull base (n = 1). An immunohistochemical analysis of the cytokeratin profile revealed for the first time that the inverted papilloma, when compared to the normal surface epithelium of the nasal cavity and the paranasal sinuses, exhibits increased expression of cytokeratin 5, typical for basal cells, and cytokeratin 13, typical for squamous epithelial cells.. Based on our results we recommend that the endonasal approach is reliable for processes restricted to the middle nasal meatus and the anterior and middle ethmoid cells. Inverted papilloma of the frontal sinus, retrobulbar and supraorbital ethmoid cells, and laterocaudal parts of the maxillary sinus should be resected via lateral rhinotomy or midfacial degloving. The findings of immunohistochemical examinations suggest that inverted papilloma is derived from a cytokeratin 5-immunoreactive cell of the basal layer of the mucosa.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Endoscopy; Female; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Neoplasm Invasiveness; Nose; Nose Neoplasms; Papilloma, Inverted; Paranasal Sinus Neoplasms; Paranasal Sinuses; Tomography, X-Ray Computed

Ultrastructural features and cytokeratin expression of inverted ductal papillomas of minor salivary gland origin were studied. Under the electron microscope, an increased number of desmosomes and mucus-like granules in some cells were the most striking features. Immunohistochemical study revealed that tumor cells displayed strongly positive reactions with cytokeratins 13 and 14, and less strong reactions with cytokeratins 7, 8, 18 and 5D3. These results support the hypothesis that an inverted ductal papilloma can be derived from the proximal portion of a salivary gland excretory duct.

Topics: Adult; Cell Membrane; Connective Tissue; Cytoplasmic Granules; Desmosomes; Endoplasmic Reticulum, Rough; Epithelium; Female; Gene Expression Regulation, Neoplastic; Humans; Immunohistochemistry; Keratins; Male; Microscopy, Electron; Middle Aged; Mucus; Papilloma, Inverted; Salivary Ducts; Salivary Gland Neoplasms; Salivary Glands, Minor

In order to investigate the changes in cellular distribution of the glycocalyces in nasal inverted papilloma, formalin-fixed, paraffin-embedded biopsy specimens of inverted papilloma were analyzed by the avidin-biotin-peroxidase complex technique for the demonstration of peanut agglutinin (PNA) receptors, concanavalin A (Canavalia ensiformis agglutinin; ConA) receptors, carcinoembryonic antigen (CEA), and keratin, and compared with normal nasal mucosa, nasal polyps, and papillary adenocarcinoma. The inverted papillomas were positive for PNA and CEA, to the same degree as papillary adenocarcinoma. Their PNA binding was related to the degree of dysplasia. The ConA reaction was intermediate between that of normal mucosa and adenocarcinoma. The results suggest that the alteration of cellular glycoprotein structure in inverted papilloma is associated with its biologic characterization.

Topics: Adult; Arachis; Carcinoembryonic Antigen; Concanavalin A; Female; Humans; Immunoenzyme Techniques; Keratins; Lectins; Male; Membrane Glycoproteins; Middle Aged; Nose Neoplasms; Papilloma, Inverted; Peanut Agglutinin; Plant Lectins

Inverted papilloma (transitional cell papilloma, inverted type) is a rare, benign urothelial tumor. The distribution of cytokeratin (CK) expression in 22 cases was investigated and compared with normal urothelium and urothelial carcinomas: CK7/8, basal increased positivity; CK13, diffuse positivity; CK18, loss of intensity and loss of umbrella cell staining; CK19, reduction of positivity; CK20, reduction of umbrella cell staining. The data indicate that the inverted papilloma is a basal cell urothelioma.

Topics: Biomarkers, Tumor; Carcinoma, Transitional Cell; Cystectomy; Electrosurgery; Humans; Immunoenzyme Techniques; Keratins; Neoplasms, Second Primary; Papilloma; Papilloma, Inverted; Urinary Bladder Neoplasms